Variability in intensively assessed mood: Systematic sources and factor structure in outpatients with opioid use disorder.

Abstract

In intensive longitudinal studies using ecological momentary assessment, mood is typically assessed by repeatedly obtaining ratings for a large set of adjectives. Summarizing and analyzing these mood data can be problematic because the reliability and factor structure of such measures have rarely been evaluated in this context, which—unlike cross-sectional studies—captures between- and within-person processes. Our study examined how mood ratings (obtained thrice daily for 8 weeks; n = 306, person moments = 39,321) systematically vary and covary in outpatients receiving medication for opioid use disorder (MOUD). We used generalizability theory to quantify several aspects of reliability, and multilevel confirmatory factor analysis (MCFA) to detect factor structures within and across people. Generalizability analyses showed that the largest proportion of systematic variance across mood items was at the person level, followed by the person-by-day interaction and the (comparatively small) person-by-moment interaction for items reflecting low arousal. The best-fitting MCFA model had a three-factor structure both at the between- and within-person levels: positive mood, negative mood, and low-arousal states (with low arousal considered as either a separate factor or a subfactor of negative mood). We conclude that (a) mood varied more between days than between moments and (b) low arousal may be worth scoring and reporting separately from positive and negative mood states, at least in a MOUD population. Our three-factor structure differs from prior analyses of mood; more work is needed to understand the extent to which it generalizes to other populations.

Time‐varying effect modeling with intensive longitudinal data: Examining dynamic links among craving, affect, self‐efficacy and substance use during addiction recovery

“…Affect/mood may be more similar within days compared to between days, as shown in one outpatient SUD sample [59]; thus, any affect report for the day could potentially be used to inform day-level risk (e.g. morning affect to predict same-day outcomes).…”

“…[57, 58]), although the strength of these moderation effects on the effect of craving could vary with time in recovery. Affect/mood may be more similar within days compared to between days, as shown in one outpatient SUD sample [59]; thus, any affect report for the day could potentially be used to inform day‐level risk (e.g. morning affect to predict same‐day outcomes).…”